FDA Tobacco Director's Concerns: Teen Smokers, E-Cigarette Regulation

November 20, 2013
Lebanon, NH

FDA Center for Tobacco Products
Director Mitchell Zeller

The FDA finally has the right set of regulatory tools to help reduce tobacco use, the leading cause of preventable cancer deaths in the United States, according to FDA Center for Tobacco Products Director Mitchell Zeller.

Zeller presented Norris Cotton Cancer Center’s 2013 C. Everett Koop Distinguished Lecture, "Keeping the Koop Vision Alive: Science-Based Tobacco Product Regulation in the 21st Century,” on Tuesday, November 19, 2013. Zeller, a graduate of Dartmouth College and the American University Washington College of Law, has been working on FDA issues for more than 30 years and became director of the FDA's Center for Tobacco Products in March 2013.

While smoking rates in the U.S. have declined, Zeller noted that one in five adults are smokers, and long-time cigarette users lose on average 13 years of life to the habit. He said that The 2009 Family Smoking Prevention and Tobacco Control Act, which assigned regulatory control of the manufacturing, marketing, and distribution of tobacco products to the FDA, brings his agency “an opportunity to have a profound impact on public health.”

Zeller outlined three agency priorities: support for research into nicotine addiction and alternative nicotine-delivery systems, stricter enforcement of laws prohibiting tobacco product sales to minors, and a new education campaign for adolescent and teen smokers.

“We have failed the at-risk, vulnerable 13-18 year olds,” said Zeller. “Every day 3,300 kids light up a tobacco product for the first time, and every day more than 700 of these kids move from experimentation to becoming regular smokers. Adolescents are “replacing” most of the adult smokers who die each year.”

The Center for Tobacco Products will launch a youth public education campaign early next year, with special efforts to reach multicultural, LGTB, and rural youth (who tend to experiment with smokeless tobacco products).

Calling the exploding e-cigarette market the “wild, wild, west,” Zeller said that there are far more questions than answers about the health effects of these products. He noted that the FDA does not regulate e-cigarettes at this time, although the center is working on developing a comprehensive nicotine regulatory policy that would include many nicotine delivery products.

The FDA is funding science-based research on these products with a focus on population health: who is using them, and how are they being used. For example, e-cigarettes may help smokers who are trying to quit, but others may be “dual users” —replacing some of their cigarettes each day with e-cigarettes—and this may significantly reduce their motivation to quit.

Other research will focus on nicotine addiction thresholds, and Zeller entertained the possibility of the development of a cigarette with nicotine levels so low that it would not cause addiction. One benefit of a product like this would help those “replacement” adolescent and teen smokers: since nicotine is the addictive chemical in cigarettes, teens could experiment with smoking—as they will continue to do—without risking life-long addiction.

About Norris Cotton Cancer Center at Dartmouth-Hitchcock
Norris Cotton Cancer Center combines advanced cancer research at Dartmouth College and the Geisel School of Medicine at Dartmouth with patient-centered cancer care provided at Dartmouth-Hitchcock Medical Center, at Dartmouth-Hitchcock regional locations in Manchester, Nashua, and Keene, NH, and St. Johnsbury, VT, and at 12 partner hospitals throughout New Hampshire and Vermont. It is one of 41 centers nationwide to earn the National Cancer Institute’s “Comprehensive Cancer Center” designation. Learn more about Norris Cotton Cancer Center research, programs, and clinical trials online at cancer.dartmouth.edu.